缺血性脑卒中后偏瘫患者脑运动功能重组的fMRI纵向研究

项目名称： 缺血性脑卒中后偏瘫患者脑运动功能重组的fMRI纵向研究

项目编号： No.81071141

项目类型： 面上项目

立项/批准年度： 2011

项目学科： 医药、卫生

项目作者： 任燕双

作者单位： 中国中医科学院广安门医院

项目金额： 10万元

中文摘要： 在缺血性脑卒中致残类型中以运动功能障碍最为多见，尤其是手部运动障碍，极大地降低了患者的生活质量。了解中枢神经系统损伤以后功能恢复(或恶化) 的机制，是寻求针对性、高效康复对策和避免潜在有害干预措施的基础。本研究以皮层下缺血性脑卒中后偏瘫患者为研究对象，利用血氧水平依赖功能磁共振成像（BOLD-fMRI）技术纵向观察发病后4周末、8周末、12周末时脑内激活的运动功能区的分布、部位的变化。研究结果提示发病4-8周为康复治疗的敏感时机，可能为临床偏瘫患者治疗选择康复治疗的时机提供初步的依据。在关于针刺效应的作用机制研究中，我们分别研究了三个不同的针刺穴位对针刺后静息态脑网络的调节模式，与既往只注重针刺的即时效应不同，重点关注针刺的持续效应对静息态脑网络的影响。结果显示不同穴位下大脑的网络连接模式不同，该研究结果初步表明针刺效应的发挥涉及中枢神经的协同作用加工机制。

中文关键词： 缺血性脑卒中；偏瘫；脑功能成像；针刺

英文摘要： Motor dysfunction is the most common symptom in ischemic stroke, particularly hand movement disorder, which greatly reduces the quality of life of patients. Understanding the functional recovery(or worse)mechanism of central nervous system after injury, is benificial for seeking targeted and efficient rehabilitation measures, and avoiding of potentially harmful interventions. In our study, we utilize the blood oxygen level dependent functional magnetic resonance imaging ( BOLD-fMRI ) technique to longitudinally observe the characteristic of the motor functional reorganization in human brain of patients with hemiplegia after onset 4 weeks, 8 weeks, 12 weeks and summarize the rule of brain reorganization in motor areas. Results suggest that 4-8 weeks after onset of stroke maybe the sensitive timing for rehabilitation treatment options, and provide preliminary evidence about the suitable opportunity to select rehabilitation therapy. In the study of the mechanism of acupuncture rehabilitation treatment, we investigated three different functional brain networks modulated by acupuncture in the resting state , which was different to the previous focus only on the immediate effects of acupuncture.We pay attention to the sustained effects of acupuncture in the resting state network. The heterogeneous modulation patterns between the two conditions may relate to the functional specific modulatory effects ofacupuncture. The preliminary findings may help us to better understand the long-lasting effects of acupuncture on the entire resting brain, as well as the neurophysiological mechanisms underlying acupuncture.

英文关键词： ischemic stroke; hemiplegia;functional magnetic resonance imaging; acupuncture